C3-Symmetric ligands in drug design: An overview of the challenges and opportunities ahead.

C3-symmetry is a type of star-shaped molecule consisting of a central core and three symmetrically attached chains. These molecules are used in drug discovery due to their unique three-fold rotational symmetry, which allows for specific binding interactions and improved molecular recognition. In this text, we provide an overview of synthetic approaches with C3-symmetry as a pharmaceutical tool: progress, challenges, and opportunities. C3-symmetric ligands offer both challenges and opportunities in drug design. Their unique symmetry can enhance binding interactions, but careful consideration of rigidity, synthetic complexity, and target compatibility is crucial. Further research and advancements in synthetic methods and modeling tools will likely drive their exploration in drug discovery, leading to the discovery of potent C3-symmetric ligands.

Directional thermal channeling: A phenomenon triggered by tight packing of heat sources.

Understanding nanoscale thermal transport is critical for nano-engineered devices such as quantum sensors, thermoelectrics, and nanoelectronics. However, despite overwhelming experimental evidence for nondiffusive heat dissipation from nanoscale heat sources, the underlying mechanisms are still not understood. In this work, we show that for nanoscale heat source spacings that are below the mean free path of the dominant phonons in a substrate, close packing of the heat sources increases in-plane scattering and enhances cross-plane thermal conduction. This leads to directional channeling of thermal transport-a novel phenomenon. By using advanced atomic-level simulations to accurately access the lattice temperature and the phonon scattering and transport properties, we finally explain the counterintuitive experimental observations of enhanced cooling for close-packed heat sources. This represents a distinct fundamental behavior in materials science with far-reaching implications for electronics and future quantum devices.

Tropical soil remediation from pyrene: Release the power of natural iron content in soil for the efficient oxidant's activation.

Natural soil minerals often contain numerous impurities, resulting in comparatively lower catalytic activity. Tropical soils are viewed as poor from soil organic matter, cations, and anions, which are considered the main impurities in the soil that are restricted to utilizing natural minerals as a catalyst. In this regard, the dissolved iron and hematite crystals that presented naturally in tropical soil were evaluated to activate oxidants and degrade pyrene. The optimum results obtained in this study were 73 %, and the rate constant was 0.0553 h-1 under experimental conditions [pyrene] = 300 mg/50 g, pH = 7, T = 55 °C, airflow = 260 mL/min, [Persulfate (PS)] = 1.0 g/L, and humic acid (HA) ( % w/w) = 0.5 %. The soil characterization analysis after the remediation process showed an increase in moieties and cracks of the soil aggregate, and a decline in the iron and aluminium contents. The scavengers test revealed that both SO4•- and O2•- were responsible for the pyrene degradation, while HO• had a minor role in the degradation process. In addition, the monitoring of by-products, degradation pathways, and toxicity assessment were also investigated. This system is considered an efficient, green method, and could provide a step forward to develop low-cost soil remediation for full-scale implementation.

A Prospective Study of Chest Trauma Scoring System as A Morbidity and Mortality Predictor in Patients with Blunt Chest Trauma.

Background: Predicting the outcome of blunt chest trauma by scoring systems is of utmost value. We aimed to assess the role of the chest trauma scoring system (CTS) in predicting blunt chest trauma outcomes among Egyptians. Methods: A prospective observational study included 45 patients admitted to the cardiothoracic emergency unit of Al-Azhar University hospitals. We documented their demographic data, history, cause and mode of trauma, vital parameters, and necessary investigations (e.g., chest X-ray and Computed Tomography) when the patient was admitted to the cardiothoracic department. All patients were assessed using the chest trauma scale (CTS) and followed up till death or discharge. Results: The patient's age ranged between 18 to 76 years (mean 42.67 years). Eighty percent were males, and 48% needed mechanical ventilation (MV). The period of MV was ranged from 1 to 5 days (mean 2.81 days). Twenty-two patients had pneumonia. Eight patients died with a chest trauma scale ranging from 2 to 12 with a median of 6. About 87 percent of patients had unilateral lesions, and 5 had criminal causes. Road traffic accidents were the most typical cause of trauma (60%). There was a significant relation between mortality among the studied patients and each MV, length of ICU duration, chest trauma scale, laterality of trauma, and associated injuries. There was a statistically significant relation between the chest trauma scale and the need for MV, the timing of MV, the presence of pneumonia, and mortality. Conclusion: CTS ≥ 6.5 can predict mortality with 100.0% sensitivity, specificity of 62.2%, and accuracy of 68.9%. However, a score of ≥ 5.5 can predict the development of pneumonia with a sensitivity of 81.8%, specificity of 78.3%, and accuracy of 80%.

Antibiotic resistance profile of common uropathogens during COVID-19 pandemic: hospital based epidemiologic study.

BACKGROUND: Antimicrobial resistance has a direct impact on the ability to treat common infections, and this was worsened during the COVID-19 pandemic. Worldwide surveillance studies are lacking and resistance rates vary spatially, so frequent local surveillance reports are required to guide antimicrobial stewardship efforts. This study aims to report our common local uropathogens and their antibiogram profiles in our community during the COVID era. METHODS: A retrospective study included patients referred to our urology units with urine culture and sensitivity. All bacterial strains were identified, and their antibiotic susceptibilities were tested. RESULTS: Out of 2581 urine culture results recruited, 30% showed microbiological proof of infection. The majority, 486 (63.4%), were isolated from females. The most frequent isolates were Escherichia coli (44.4%) and Staphylococcus aureus (17.8%). The resistance rates ranged from 26.9 to 79.7%. Piperacillin-tazobactam antibiotic had the lowest resistance rate. The multi-drug resistance pattern was recorded in 181 (23.9%) of the isolates; 159/597 (26.6%) Gram-negative and 22/160 (13.8%) Gram-positive isolates. CONCLUSIONS: Alarming rates of antimicrobial resistance were detected, which stresses the significance of following infection control policies and establishing national antimicrobial stewardship standards.

Different Dimensionalities, Morphological Advancements and Engineering of g-C3 N4 -Based Nanomaterials for Energy Conversion and Storage.

Graphitic carbon nitride (g-C3 N4 ) has gained tremendous interest in the sector of power transformation and retention, because of its distinctive stacked composition, adjustable electronic structure, metal-free feature, superior thermodynamic durability, and simple availability. Furthermore, the restricted illumination and extensive recombination of photoexcitation electrons have inhibited the photocatalytic performance of pure g-C3 N4 . The dimensions of g-C3 N4 may impact the field of electronics confinement; as a consequence, g-C3 N4 with varying dimensions shows unique features, making it appropriate for a number of fascinating uses. Even if there are several evaluations emphasizing on the fabrication methods and deployments of g-C3 N4 , there is certainly an insufficiency of a full overview, that exhaustively depicts the synthesis and composition of diverse aspects of g-C3 N4 . Consequently, from the standpoint of numerical simulations and experimentation, several legitimate methodologies were employed to deliberately develop the photocatalyst and improve the optimal result, including elements loading, defects designing, morphological adjustment, and semiconductors interfacing. Herein, this evaluation initially discusses different dimensions, the physicochemical features, modifications and interfaces design development of g-C3 N4 . Emphasis is given to the practical design and development of g-C3 N4 for the various power transformation and inventory applications, such as photocatalytic H2 evolution, photoreduction of CO2 source, electrocatalytic H2 evolution, O2 evolution, O2 reduction, alkali-metal battery cells, lithium-ion batteries, lithium-sulfur batteries, and metal-air batteries. Ultimately, the current challenges and potential of g-C3 N4 for fuel transformation and retention activities are explored.

Reducing disinfection byproduct precursors through coagulation enhancement as particle weight and size control using potassium permanganate.

The widespread use of chlorine pre-oxidation in water purification has been limited in several countries owing to the production of carcinogenic byproducts when combined with naturally occurring organic matter. This study investigates the efficient use of potassium permanganate (KMnO4) pretreatment and coagulation enhancement as particle size and molecular weight distribution controlling parameters. KMnO4 pretreatment significantly reduced the apparent molecular weight of humic acid due to KMnO4 reduction and the continuous generation of manganese dioxide (MnO2) formed in situ under neutral and alkaline conditions. The MnO2 formed in situ had adsorption characteristics that enabled it to form large and stable flocs with the hydrolysis products of aluminum sulfate. However, under acidic conditions, KMnO4 pretreatment exhibited strong oxidation characteristics due to Mn(VII) reduction to Mn(II), and the mean particle floc size was the same as without KMnO4 pretreatment. Overall, KMnO4 pretreatment is a useful alternative strategy for traditional pre-oxidation using chlorine and a good coagulant enhancement agent in neutral and basic media.

Monitoring of health status, performance and transcript abundance of some genes in dairy heifers produced by embryo transfer or artificial insemination.

The use of multiple ovulation and embryo transfer (MOET) technology in the dairy cattle industry has increased dramatically in recent decades for the production of offspring from genetically superior cows. Yet, its long-term ramifications on adult performance have not been adequately clarified. Therefore, this study targeted comparing dairy heifers born after the transfer of in vivo-produced embryos (MOET-heifers, n = 400) and those born after artificial insemination (AI-heifers, n = 340). The performance of MOET-heifers and AI-heifers was compared from birth till completion of the first lactation regarding health, fertility and some lactational performance parameters. The transcript abundance of several genes was also assessed in peripheral blood leukocytes (PBWC). Results showed greater pre-weaning mortalities, greater likelihood of being culled as a nulliparous heifer and younger age at first insemination in AI-heifers (p < .001). At their first calving, primiparous MOET-heifers experienced a greater (p < .01) incidence of stillbirth compared to primiparous AI-heifers. In spite of that, primiparous AI-heifers were more likely to be culled due to infertility (p < .001), took a greater number of inseminations to achieve pregnancy (p < .01) and displayed a longer first calving interval. There was a similar lactational performance between the two groups. Upregulation of the transcript levels of TAC3, LOC522763, TFF2, SAXO2, CNKSR3 and ALAS2 was interestingly observed in primiparous MOET-heifers, compared to primiparous AI-heifers. In conclusion, MOET-heifers were less likely to be culled during the first year of life, had superior reproductive performance versus AI-heifers during their first lactation and expressed upregulation of genes associated with fertility.

Synthesis and Characterization of Aminoamidine-Based Polyacrylonitrile Fibers for Lipase Immobilization with Effective Reusability and Storage Stability.

Lipases are extensively utilized industrial biocatalysts that play an important role in various industrial and biotechnological applications. Herein, polyacrylonitrile (PAN) was treated with hexamethylene diamine (HMDA) and activated by glutaraldehyde, then utilized as a carrier support for Candida rugosa lipase. In this regard, the morphological structure of modified PAN before and after the immobilization process was evaluated using FTIR and SEM analyses. The immobilized lipase exhibited the highest activity at pH 8.0, with an immobilization yield of 81% and an activity of 91%. The optimal pH and temperature for free lipase were 7.5 and 40 °C, while the immobilized lipase exhibited its optimal activity at a pH of 8.0 and a temperature of 50 °C. After recycling 10 times, the immobilized lipase maintained 76% of its activity and, after 15 reuses, it preserved 61% of its activity. The lipase stability was significantly improved after immobilization, as it maintained 76% of its initial activity after 60 days of storage. The calculated Km values were 4.07 and 6.16 mM for free and immobilized lipase, and the Vmax values were 74 and 77 µmol/mL/min, respectively. These results demonstrated that synthetically modified PAN is appropriate for immobilizing enzymes and has the potential for commercial applications.

Impact of Ag/ZnO Reinforcements on the Anticancer and Biological Performances of CA@Ag/ZnO Nanocomposite Materials.

In this study, an unpretentious, non-toxic, and cost-effective dissolution casting method was utilized to synthesize a group of anticancer and biologically active hybrid nanocomposite materials containing biopolymer cellulose acetate. Pristine ZnO and Ag(0.01, 0.05, 0.1)/ZnO hybrid nanofillers based on variable Ag NP loadings were prepared via green procedures in the presence of gum arabic (GA). The chemical structures and the morphological features of the designed nanocomposite materials were investigated by PXRD, TEM, SEM, FTIR, TGA, and XPS characterization techniques. The characterization techniques confirmed the formation of CA@Ag(0.01, 0.05, 0.1)/ZnO hybrid nanocomposite materials with an average crystallite size of 15 nm. All investigated materials showed two degradation steps. The thermal stability of the fabricated samples was ranked in the following order: CA/ZnO < CA@Ag(0.01)/ZnO < CA@Ag(0.05)/ZnO = CA@Ag(0.1)/ZnO. Hence, the higher Ag doping level slightly enhanced the thermal stability. The developed nanocomposites were tested against six pathogens and were used as the target material to reduce the number of cancer cells. The presence of Ag NPs had a positive impact on the biological and the anticancer activities of the CA-reinforced Ag/ZnO composite materials. The CA@Ag(0.1)/ZnO hybrid nanocomposite membrane had the highest antimicrobial activity in comparison to the other fabricated materials. Furthermore, the developed CA@Ag(0.1)/ZnO hybrid nanocomposite material effectively induced cell death in breast cancer.

Laparoscopic Sleeve Gastrectomy with Roux en-Y Bypass (A Novel Modification) for Morbid Obesity: A Prospective Observational Study.

Background: Recently, obesity witnessed a dramatic increase and its related comorbidities have grown. Bariatric surgeries were developed to reduce weight. However, all techniques had their advantages and shortages. In this work, we aimed to assess our new modification of combining sleeve gastrectomy with Roux en-y bypass for the management of obesity, hoping to gain benefits from both techniques to increase the excess bodyweight loss (EBW%). Methods: The study was a prospective observational study on 23 Morbidly obese patients. The study was held from January 2020 to April 2022. The recruited patients were submitted to detailed clinical assessment and investigations to check fitness for surgery. Besides operative data, any intra- or post-operative complications were recorded. Each patient was followed up for at least one year. The follow-up visits were scheduled at regular intervals (one week, one month, six months, and twelve months). Results: The mean operative time was 113.91 minutes (65-150). No intraoperative complications or conversion. There was intraluminal bleeding in one patient within 48 hours postoperatively with successful conservative management. There was a complete cure of diabetes mellitus (DM) for 5, 2, and 3 patients and antidiabetic drugs were reduced for 64.3%, 21.43%, and 7.14% at 1, 6, and 12 months follow up respectively. Hypertension was cured in 1,1,2 patients, and antihypertensives were reduced for 2,1,1 patient, at 1, 6, and 12 months follow up respectively. EWL% was 14.4%, 40.78%, and 73.74% at 1,6,12 months follow up respectively. Hemoglobin concentration and ionized calcium improved over time. Finally, serum albumin at 1, 6, and 12 months follow-up was 3.64, 3.58, 3.78 g/dL respectively. Conclusion: New modifications of combining LSG and LRYGB have shown to be safe and effective procedures. In addition, it is associated with minimal postoperative nutritional complications and permits complete visualization of the biliary system using endoscopy.

Heat stress during critical windows of the oestrous cycle and risk of pregnancy establishment in embryo-recipient dairy heifers.

This study aimed to determine effects of exposure of recipient dairy heifers to heat stress (THI ≥ 73) during the oestrous cycle coinciding with embryo transfer (ET) on the risk of pregnancy establishment after transfer of in vivo produced embryos. Recipients exposed to THI values ≥73 during Days zero (recipient estrus), 7 (day of ET), 14 (seven days after ET), 15 and 16 (maternal recognition of pregnancy) of the ET cycle were considered as heat-stressed heifers (n = 254), while heifers in the control group (n = 470) were not exposed to THI ≥ 73 at any of the previous days. Results revealed no significant effects of any of the investigated factors on the risk of pregnancy following ET. However, the mean THI above 77 was associated with a drastic numerical decrease in PR/ET (36.63%), when compared to a mean THI 72 (78.78%). In addition, PR/ET after transfer of second- and third-grade embryos were numerically lower in heat-stressed recipients, compared with first-grade embryos (41.17% vs. 56.36%, respectively). Our findings confirmed that transfer of blastocysts was associated with numerically higher PR/ET in heat-stressed and control recipients, as compared to morula stage. Interestingly, PR/ET tended to be higher when sexed embryos were transferred to the control recipients compared with heat-stressed ones. In conclusion, PR/ET in dairy heifers was not significantly affected by heat stress during critical windows of their oestrous cycle coinciding with ET, whereas transfer of sexed embryos gives lower results under conditions of heat stress.

Closed-form existence conditions for bandgap resonances in a finite periodic chain under general boundary conditions.

Bragg scattering in periodic media generates bandgaps, frequency bands where waves attenuate rather than propagate. Yet, a finite periodic structure may exhibit resonance frequencies within these bandgaps. This is caused by boundary effects introduced by the truncation of the nominal infinite medium. Previous studies of discrete systems determined existence conditions for bandgap resonances, although the focus has been limited to mainly periodic chains with free-free boundaries. In this paper, we present closed-form existence conditions for bandgap resonances in discrete diatomic chains with general boundary conditions (free-free, free-fixed, fixed-free, or fixed-fixed), odd or even chain parity (contrasting or identical masses at the ends), and the possibility of attaching a unique component (mass and/or spring) at one or both ends. The derived conditions are consistent with those theoretically presented or experimentally observed in prior studies of structures that can be modeled as linear discrete diatomic chains with free-free boundary conditions. An intriguing case is a free-free chain with even parity and an arbitrary additional mass at one end of the chain. Introducing such an arbitrary mass underscores a transition among a set of distinct existence conditions, depending on the type of chain boundaries and parity. The proposed analysis is applicable to linear periodic chains in the form of lumped-parameter models, examined across the frequency spectrum, as well as continuous granular media models, or similar configurations, examined in the low-frequency regime.

Smart Cognitive IoT Devices Using Multi-Layer Perception Neural Network on Limited Microcontroller.

The Internet of Things (IoT) era is mainly dependent on the word "Smart", such as smart cities, smart homes, and smart cars. This aspect can be achieved through the merging of machine learning algorithms with IoT computing models. By adding the Artificial Intelligence (AI) algorithms to IoT, the result is the Cognitive IoT (CIoT). In the automotive industry, many researchers worked on self-diagnosis systems using deep learning, but most of them performed this process on the cloud due to the hardware limitations of the end-devices, and the devices obtain the decision via the cloud servers. Others worked with simple traditional algorithms of machine learning to solve these limitations of the processing capabilities of the end-devices. In this paper, a self-diagnosis smart device is introduced with fast responses and little overhead using the Multi-Layer Perceptron Neural Network (MLP-NN) as a deep learning technique. The MLP-NN learning stage is performed using a Tensorflow framework to generate an MLP model's parameters. Then, the MLP-NN model is implemented using these model's parameters on a low cost end-device such as ARM Cortex-M Series architecture. After implementing the MLP-NN model, the IoT implementation is built to publish the decision results. With the proposed implemented method for the smart device, the output decision based on sensors values can be taken by the IoT node itself without returning to the cloud. For comparison, another solution is proposed for the cloud-based architecture, where the MLP-NN model is implemented on Cloud. The results clarify a successful implemented MLP-NN model for little capabilities end-devices, where the smart device solution has a lower traffic and latency than the cloud-based solution.

Physics of surface vibrational resonances: pillared phononic crystals, metamaterials, and metasurfaces.

The introduction of engineered resonance phenomena on surfaces has opened a new frontier in surface science and technology. Pillared phononic crystals, metamaterials, and metasurfaces are an emerging class of artificial structured media, featuring surfaces that consist of pillars-or branching substructures-standing on a plate or a substrate. A pillared phononic crystal exhibits Bragg band gaps, while a pillared metamaterial may feature both Bragg band gaps and local resonance hybridization band gaps. These two band-gap phenomena, along with other unique wave dispersion characteristics, have been exploited for a variety of applications spanning a range of length scales and covering multiple disciplines in applied physics and engineering, particularly in elastodynamics and acoustics. The intrinsic placement of pillars on a semi-infinite surface-yielding a metasurface-has similarly provided new avenues for the control and manipulation of wave propagation. Classical waves are admitted in pillared media, including Lamb waves in plates and Rayleigh and Love waves along the surfaces of substrates, ranging in frequency from hertz to several gigahertz. With the presence of the pillars, these waves couple with surface resonances richly creating new phenomena and properties in the subwavelength regime and in some applications at higher frequencies as well. At the nanoscale, it was shown that atomic-scale resonances-stemming from nanopillars-alter the fundamental nature of conductive thermal transport by reducing the group velocities and generating mode localizations across the entire spectrum of the constituent material well into the terahertz regime. In this article, we first overview the history and development of pillared materials, then provide a detailed synopsis of a selection of key research topics that involve the utilization of pillars or similar branching substructures in different contexts. Finally, we conclude by providing a short summary and some perspectives on the state of the field and its promise for further future development.

Indomethacin can induce cell death in rat gastric parietal cells through alteration of some apoptosis- and autophagy-associated molecules.

In clinical medicine, indomethacin (IND, a non-steroidal anti-inflammatory drug) is used variously in the treatment of severe osteoarthritis, rheumatoid arthritis, gouty arthritis or ankylosing spondylitis. A common complication found alongside the therapeutic characteristics is gastric mucosal damage. This complication is mediated through apoptosis and autophagy of the gastrointestinal mucosal epithelium. Apoptosis and autophagy are critical homeostatic pathways catalysed by caspases downstream of the gastrointestinal mucosal epithelial injury. Both act through molecular signalling pathways characterized by the initiation, mediation, execution and regulation of the cell regulatory cycle. In this study we hypothesized that dysregulated apoptosis and autophagy are associated with IND-induced gastric damage. We examined the spectra of in vivo experimental gastric ulcers in male Sprague-Dawley rats through gastric gavage of IND. Following an 18-hour fast, IND was administered to experimental rats. They were sacrificed at 3-, 6- and 12-hour intervals. Parietal cells (H+ , K+ -ATPase ß-subunit assay) and apoptosis (TUNEL assay) were determined. The expression of apoptosis-signalling caspase (caspases 3, 8, 9 and 12), DNA damage (anti-phospho-histone H2A.X) and autophagy (MAP-LC3, LAMP-1 and cathepsin B)-related molecules in gastric mucosal cells was examined. The administration of IND was associated with gastric mucosal erosions and ulcerations mainly involving the gastric parietal cells (PCs) of the isthmic and upper neck regions and a time-dependent gradual increase in the number of apoptotic PCs with the induction of both apoptotic (upregulation of caspases 3 and 8) cell death and autophagic (MAP-LC3-II, LAMP-1 and cathepsin B) cell death. Autophagy induced by fasting and IND 3 hours initially prompted the degradation of caspase 8. After 6 and 12 hours, damping down of autophagic activity occurred, resulting in the upregulation of active caspase 8 and its nuclear translocation. In conclusion we report that IND can induce time-dependent apoptotic and autophagic cell death of PCs. Our study provides the first indication of the interactions between these two homeostatic pathways in this context.

HHV 6-7 reactivation causing Pityriasis Rosea and labyrinthitis: A case report.

Pityriasis Rosea (PR) and labyrinthitis are most commonly caused by viral infections. PR presents with a characteristic rash while labyrinthitis presents with vertigo, tinnitus and hearing loss. However, the coexistence of PR and Labyrinthitis remains an uncommon event. Human Herpes Virus (HHV) 6 and 7, are common infections in childhood, and their reactivation causes Pityriasis Rosea. But these viruses are not known to have any involvement with the inner ear or the 8th cranial nerve (CN).

Ultra-structural study of the indomethacin-induced apoptosis and autophagy in rat gastric parietal cells.

BACKGROUND AND AIM OF THE WORK: Indomethacin (IND), a non-steroidal anti-inflammatory drug, can induce gastric mucosal ulcerations. To date, the ultra-structural changes in the parietal cells (PCs) of the gastric mucosa following the intake of IND are mostly unknown. We carried out the current investigation to get insights into this issue. MATERIALS AND METHODS: We established an animal model consisting of 35 adult male Sprague Dawley rats. The animals were divided into three groups, including; control (normal feeding), fasting, and indomethacin-treated groups. After treatment of 18-h fasting rats with IND, they were sacrificed at 3, 6, and 12-h intervals. The morphological features, including the apoptotic, and autophagic changes in the gastric mucosa PCs were examined using transmission electron microscopy. RESULTS: In normal feeding animals (control group), the gastric PCs were present in various stages of activity. Fasting was associated with the predominance of the inactive parietal cells with features of up-regulated autophagy. In the IND -treated animals (at 3-h interval), PCs showed prominent autophagic changes, and subtle apoptotic cell death. In the IND -treated animals (at 6-12-h interval), PCs showed prominent apoptotic changes, and subtle autophagic features. CONCLUSIONS: Our study indicates that IND treatment could induce gastropathy through time-dependent alterations in the autophagic and apoptotic machinery of PCs. Further studies are needed to examine the underlying molecular mechanisms.

Increased expression of TGF-ß protein in the lesional skins of melasma patients following treatment with platelet-rich plasma.

Background: Melasma is a common acquired facial hyperpigmented skin disorder. Platelet-rich plasma (PRP) is autologous plasma containing higher than normal platelets concentrations. Recently, PRP has been used as a therapeutic modality in melasma with significant clinical improvement, possibly due to its abundant contents of growth factors such as TGF-ß. The latter represents a natural multifunctional polypeptide that negatively regulates melanocyte differentiation and therefore reduces skin hyperpigmentation. To date, the expression pattern of TGF-ß protein in skin of melasma patients following PRP injection is unknown. Here we hypothesize that "injection of PRP in the lesional skin of melasma patients is associated with alterations of TGF-ß protein expression".Patients and Methods: The study included 20 adult patients with melasma. Autologous PRP was delivered into the lesional skin either through microneedling or as intradermal microinjections. TGF-ß protein expression was immunohistochemically examined in the perilesional and lesional skins before and after PRP treatment and in the healthy skins of nine volunteers (control group).Results: TGF-ß protein was expressed within the epidermis, dermal adnexal structures, vascular endothelium, nerves and arrector pili muscle fibers of the healthy skins (control group), perilesional and lesional skins of melasma patients before and after treatment with PRP. Before treatment with PRP, the expression ofTGF-ß protein in the lesional (1.26 ± 0.41) and perilesional (1.68 ± 0.51) skins of melasma patients were significantly lower than that in the healthy skins (2.26 ± 0.37, p value<.05). After treatment with PRP, the expression of TGF-ß protein was significantly increased in the lesional (2.15 ± 0.44) skin of melasma patients.Conclusions: Our study provides the first indication about increased TGF-ß protein expression in skin of melasma patients after PRP treatment. The alterations of TGF-ß protein in skin of melasma patients not only support its roles in the development of this condition but also have some therapeutic ramifications.

Outcomes of segmental femoral artery pseudoaneurysm in patients with Behçet's disease: a single center's experience.

BACKGROUND: Behçet's disease (BD) is an autoimmune condition that involves multiple systems. The most common arterial manifestation in BD patients is pseudoaneurysm, which has higher frequency than aneurysm formation. OBJECTIVES: To clarify the importance of profunda femoris artery in BD pseudoaneurysm, and present a new method for identifying healthy segments for anastomosis. METHODS: Fifteen patients presented at a vascular department with pseudoaneurysms of the common femoral (CFA) and superficial femoral artery (SFA), were diagnosed with BD and underwent surgical intervention at Kasr al Ainy hospitals over 2 years. RESULTS: All patients were male. The patients ranged in age from 30 to 40 years (mean, 33.8±2.6 years). Mean duration of the disease was 5±3.4 years. Eight (53.3%) CFA graft interpositions, six (40%) mid SFA graft interpositions, and one (6.66) distal SFA graft interposition were performed. Eight (53.3%) of these operations were performed using Dacron graft and sartorius flap, three (20%) were performed with a polytetrafluoroethylene graft, and four (26.66) with a great saphenous vein graft. Two cases (13.33%) were accidentally discovered while four cases (26.66%) had short distance claudication, four cases (26.66%) had pain at rest, and five cases (33.33%) presented with pulsatile swelling correlated with pseudoaneurysm size (p = 0.005). Patients were followed-up over 1 year for new aneurysms and recurrence. CONCLUSIONS: Surgical repair with muscle flap coverage, with or without ligation of profunda femoris artery, does not affect prognosis. An alternative method for identifying healthy segments of femoral artery may be frozen section and examination of the artery to decrease the risk of recurrence at the site of anastomosis.

CONTEXTO: A doença de Behçet (DB) é uma enfermidade autoimune que envolve múltiplos sistemas. A manifestação arterial mais comum em pacientes com DB é o pseudoaneurisma, que tem uma frequência mais alta do que a formação de aneurismas. OBJETIVOS: Esclarecer a importância da artéria femoral profunda no pseudoaneurisma por DB e apresentar um novo método para a identificação de segmentos saudáveis para anastomose. MÉTODOS: Quinze pacientes se apresentaram em um departamento vascular com pseudoaneurismas da artéria femoral comum (AFC) e artéria femoral superficial (AFS), foram diagnosticados com DB e foram submetidos a intervenção cirúrgica em hospitais Kasr al Ainy ao longo de 2 anos. RESULTADOS: Todos os pacientes eram do sexo masculino. A idade variou de 30 a 40 anos (média, 33,8±2,6 anos). A duração média da doença foi de 5±3,4 anos. Foram realizadas oito (53,3%) interposições de enxerto na AFC, seis (40%) interposições de enxerto na AFS média, e uma (6.66) interposição de enxerto na AFS distal. Oito (53,3%) das cirurgias foram realizadas utilizando enxertos de Dacron e retalho sartório, três (20%) com enxertos de politetrafluoroetileno, e quatro (26,66) com enxertos da veia safena magna. Dois casos (13,33%) foram descobertos ao acaso, ao passo que quatro casos (26,66%) apresentaram claudicação em curta distância, quatro (26,66%) apresentaram dor em repouso, e cinco casos (33,33%) apresentaram com inchaço pulsátil correlacionado com o tamanho do pseudoaneurisma (p = 0.005). Os pacientes foram seguidos por 1 ano para novos aneurismas e recorrência. CONCLUSÕES: O reparo cirúrgico com cobertura de retalho muscular, com ou sem ligadura da artéria femoral profunda, não afeta o prognóstico. Um método alternativo para identificar segmentos saudáveis da artéria femoral pode ser o exame de congelação e a avaliação da artéria para diminuir o risco de recorrência no local da anastomose.